Provider Demographics
NPI:1265526180
Name:LUSBY, FRANKLIN W JR (MD)
Entity type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:W
Last Name:LUSBY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9850 GENESEE AVE
Mailing Address - Street 2:STE 220
Mailing Address - City:LAJOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037
Mailing Address - Country:US
Mailing Address - Phone:858-459-6200
Mailing Address - Fax:858-459-2025
Practice Address - Street 1:9850 GENESEE AVE
Practice Address - Street 2:STE 220
Practice Address - City:LAJOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-459-6200
Practice Address - Fax:858-459-2025
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG41830207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G418303Medicaid
G41830CMedicare ID - Type Unspecified
CA00G418303Medicaid